Anemias in ancient Egyptian child mummies: Computed tomography investigations in European museums

The aim of this study was to investigate the prevalence of anemias in ancient Egyptian child mummies. Whole-body computed tomography (CT) examinations of 21 ancient Egyptian child mummies from European museums were evaluated for estimation of sex and age at death. CT examinations were systematically assessed for skeletal effects of anemias using a clinical radiological approach as well as quantitative measurements of the thickness of the cranial vault and diploe. Additionally, the technical feasibility to assess porotic hyperostosis on the available CT data was examined. Twelve children were assessed as male and seven as female, and in two, the sex was indeterminate. The estimated age at death ranged from about 1 year to 12-14 years. One case showed radiological signs of thalassemia (beta-thalassemia major) at the cranial vault and postcranial skeleton. Additionally, this case had a macroglossia that probably indicated Beckwith-Wiedemann syndrome. Quantitative measurements confirmed a high variability of cranial vault thickness and diploe thickness. Compared with clinical reference values, seven out of the 21 (33%) child mummies had a pathological enlargement of the frontal cranial vault that represents a typical finding of chronic hemolytic anemia and iron deficiency anemia. Assessment of porotic hyperostosis was not feasible on the available CT examinations as the image quality was not sufficient for this examination. In conclusion, pathological enlargement of the frontal cranial vault as an indicator for chronic hemolytic anemia and iron deficiency anemia had a high prevalence, especially in the younger children. The mummy with radiological signs of thalassemia seems to be the first case with radiological evidence of skeletal effects of this anemia to the cranial vault and postcranial skeleton from ancient Egypt.